In other words, the bulk of their health care needs are met outside the VA system. As you can see from the following chart, which broadly summarizes data reported here, the VA is NOT the primary health care delivery system for most vets:

Nearly 80 percent of enrolled veterans have access to other health care coverage, and data from VHA indicate that most enrollees with other coverage rely on VHA for only part of their medical care. Veterans are particularly likely to turn to VHA for outpatient care and for certain services--such as mental health and substance abuse counseling--on which VHA has put particular emphasis and for which many veterans may not have private coverage. Most enrollees rely on other providers for emergency services and inpatient hospital care. Enrollees may choose one provider over another for various reasons, including travel time, out-of-pocket costs, and perceived quality of care for a particular type of service.